Greendyke, Spencer D

Greendyke, Spencer D is an sole proprietor health care provider with primary practice located at 3318 N Grand Mill Ln , Coeur D Alene ID 83814-5689. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Greendyke, Spencer D can be contacted via phone (208) 277-1060.

Contact Information

Primary practice address
3318 N Grand Mill Ln Coeur D Alene ID 83814-5689
Phone: (208) 277-1060
Fax: (208) 277-1065
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X M9110 Idaho

Profile Details

NPI number 1639165038
LBN Legal business name Greendyke, Spencer D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2005
Last updated Feb 23rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1639165038 NPPES
Idaho MEDICAID 807145800

Popular Providers